Chagas Disease Prevalence in a Safety-Net Prenatal Clinic in Northern Virginia [ID 1093]

INTRODUCTION: Chagas disease is a neglected tropical disease traditionally acquired through vector exposure in rural Latin America. Congenital transmission occurs in 2–4% of pregnancies, infrequently causing premature birth and Torch-like syndrome in the neonate. Long-term cardiac consequences can be found in both an infected mother and the infected child. Routine testing is suggested by the World Health Organization and PAHO, but has not been adopted in the United States, even though studies have demonstrated high prevalence of disease in the immigrant community. In this setting, the INOVA Cares Clinic for Women began testing all pregnant women at 28 weeks or later in pregnancy for Trypanosoma cruzi infection METHODS: Beginning in July 2023, all women presenting either at or after their 28th week in pregnancy underwent Hemagen ELISA T cruzi IgG testing, followed by confirmatory serologic testing at the Centers for Disease Control and Prevention if positive. RESULTS: A total of 2,100 pregnant women have been tested as of September 2024. Of those, 18 (0.9%) have confirmed positive for T cruzi infection. No neonates have been diagnosed at birth, but one 15-year-old child of a seropositive mother was diagnosed. CONCLUSIONS/IMPLICATIONS: In this safety-net clinic that cares for women at risk for Chagas disease, a higher-than-expected prevalence of T cruzi infection was found. Consideration should be given to establishing screening programs in settings in which pregnant women from endemic regions in Latin America get prenatal care.